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510(k) Data Aggregation

    K Number
    K162948
    Manufacturer
    Date Cleared
    2017-08-08

    (291 days)

    Product Code
    Regulation Number
    N/A
    Panel
    Dental
    Reference & Predicate Devices
    Predicate For
    N/A
    Why did this record match?
    Reference Devices :

    K050180, K123215

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    Aluminum Chloride impregnated retraction material are for the temporary retraction of the gingival margins and hemostasis procedures. The Retraction Cord is place the gingival tissues for a short period prior to making an impression or for other restorative procedures.

    Device Description

    As part of a tissue management procedure, Styptin, Hemogin-L, Hemodettes, and GingiGEL are aluminum chloride containing astringent/ hemostatic solutions and gels that are intended to be supplied with gingival retraction cord or cotton pellets that are either pre-impregnated or for end-user impregnation by soaking the cords or cotton pellets in these solutions. The aluminum chloride impregnated retraction material is then packed into the sulcus to temporarily displace gingival tissue to expose the sub-gingival margins and control sulcular seepage and hemorrhage for impression taking and other restorative treatments. The supplied retraction material is available as an aqueous aluminum chloride solution or gel and either unit-dose 2"-pieces of braided cotton cord, braided cotton-polyester cord, or unit-dose cotton pellets.

    AI/ML Overview

    The provided document is a 510(k) Pre-market Notification from the FDA for dental retraction materials (Styptin, Hemogin-L, Hemodettes, and GingiGEL Aluminum Chloride Impregnated Retraction Cord/Materials). This type of document is focused on demonstrating substantial equivalence to existing legally marketed devices, rather than establishing acceptance criteria and conducting studies to prove performance against those criteria in the way one might for a novel device or software.

    Therefore, much of the requested information regarding detailed acceptance criteria and a specific study proving the device meets those criteria (especially clinical performance, AI/ML specific details like sample sizes for training/test sets, expert adjudication, or MRMC studies) is not applicable or not present in an FDA 510(k) summary for this type of device.

    Here's a breakdown of what information can be extracted or inferred from the document based on your request:


    1. Table of Acceptance Criteria and Reported Device Performance

    Formal acceptance criteria, as in numerical thresholds for accuracy, sensitivity, or specificity commonly seen for diagnostics, are not presented for this device. Instead, the "acceptance criteria" are implied through demonstration of substantial equivalence to predicate devices, focusing on shared intended use, indications for use, fundamental technological characteristics, and safety profiles. Performance is primarily assessed through non-clinical testing and comparison of characteristics.

    Acceptance Criteria Category (Derived from Substantial Equivalence)Reported Device Performance (as demonstrated by comparison and non-clinical tests)
    Intended UseSame as predicates: Temporary retraction of gingival margins and hemostasis procedures.
    Indications for UseSame as predicates: Temporary retraction of gingival margins and hemostasis for impression taking or other restorative procedures.
    Target UsersSame as predicates: Licensed dental professionals.
    Primary Mode of ActionSame as predicates: Mechanical displacement of gingival tissues.
    Astringent/Hemostatic AgentAluminum Chloride (similar to reference predicates; primary predicate uses Aluminum Potassium Sulfate).
    AlCl3 Content (weight/volume %)GingiGel: 20%; Styptin: 20%; Hemogin-L: 25%; Hemodettes: 20% (Comparable to reference predicates Expa-syl (15%) and ViscoStat Clear (25%)).
    Contact Time< 5 minutes (comparable to predicates: < 5 minutes, 1-2 minutes, 1-3 minutes).
    Shelf LifeGingiGEL, Styptin, Hemogin-L: 36 months; Hemodettes: 24 months (comparable to predicates ranging from 24 to 42 months).
    Material Compatibility (Biocompatibility)Meets requirements per ISO 10993 (same as predicates).
    Physical ConfigurationVariations (gel coated braid, aqueous solution, cotton pellets) are considered comparable to predicates (knitted/braided cord, paste, aqueous gel).
    Non-Clinical PerformanceAluminum chloride content assessment, shelf life assessment, visual inspection, material composition analysis, cutting test, water contact test. Performed on "worst-case" product.
    Biocompatibility TestingMeets ISO 10993-1, ISO 10993-5 (in vitro cytotoxicity), and ISO 7405 (dental biocompatibility).

    2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

    • Sample Size for Test Set: This is a non-clinical device involving dental retraction materials (cords, gels, solutions). The performance testing described is primarily non-clinical (material composition, physical properties, biocompatibility). Therefore, there isn't a "test set" in the sense of patient data. The non-clinical tests were performed on the device products themselves, and the sample sizes for those specific tests are not detailed in this summary document.
    • Data Provenance: Not applicable as it's primarily non-clinical testing described.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

    • Not applicable. This device is not a diagnostic or AI/ML device that would require expert-established ground truth for a test set.

    4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

    • Not applicable. This device is not a diagnostic or AI/ML device that would require expert adjudication for a test set.

    5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

    • Not applicable. This device is a manual dental tool/material, not an AI-assisted diagnostic. The document explicitly states: "Clinical performance testing has not been performed for the proposed device."

    6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

    • Not applicable. This is not an algorithm or AI device.

    7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

    • Not applicable. For the non-clinical tests conducted (e.g., biocompatibility, chemical analysis), the "ground truth" would be established by validated analytical methods and regulatory standards (e.g., ISO standards for biocompatibility), not expert consensus on patient cases or pathology.

    8. The sample size for the training set

    • Not applicable. This is not an AI/ML device with a training set.

    9. How the ground truth for the training set was established

    • Not applicable. This is not an AI/ML device with a training set.
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